Dominion Cove Point LNG, LP
Original Volume No. 1
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Effective Date: 05/01/2003, Docket: RP03-341-000, Status: Effective
Original Sheet No. 493 Original Sheet No. 493 : Effective
REQUEST FOR SERVICE FORM
9. DELIVERY POINT(S)
A. For each requested Delivery Point, list the following:
1. Delivery Measuring Station Name.
2. Quantity to be delivered by Seller (dth/day).
3. Name of downstream entity receiving gas.
Primary Receipt Point: 1. _____________________________
Secondary Receipt Point: 1. _____________________________
10. REGULATORY APPROVALS
List any regulatory approvals required by Requestor to commence service:
Requestor certifies that the information contained in this Request for Service is complete
and accurate to the best of Requestor's knowledge and that all regulatory approvals that are
necessary for gas to be received into and delivered from Seller's facilities have
been obtained or applied for by Requestor except as otherwise noted.
Signed By :
Date : / /